How much rates vary
Facilitymedian $1,549 · 10th to 90th $813 to $3,715Professionalmedian $1,288 · 10th to 90th $912 to $1,950
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $6,918.31 | Facility | None | $1,288.25 | $4,897.79 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,318.26 | $1,318.26 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $2,754.23 | Facility | None | $1,548.82 | $1,584.89 | $2,754.23 |
BCBS Michigan Setting Professional Modifier None Typical Low $812.83 Median $1,862.09 Typical High $1,949.84 | Professional | None | $812.83 | $1,862.09 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,949.84 | Professional | None | $707.95 | $1,000.00 | $1,949.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $162.18 Median $2,398.83 Typical High $5,754.40 | Facility | None | $162.18 | $2,398.83 | $5,754.40 |
Health Alliance Plan Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,318.26 | Professional | None | $912.01 | $1,174.90 | $1,318.26 |
Priority Health Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Priority Health Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,819.70 | Professional | None | $676.08 | $912.01 | $1,819.70 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $5,011.87 | Facility | None | $602.56 | $1,230.27 | $5,011.87 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Professional | None | $977.24 | $1,096.48 | $1,288.25 |
13 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
BCBS Michigan Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | 50 · Both sides | $2,089.30 | $2,089.30 | $2,089.30 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $645.65 | $660.69 | $660.69 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $199.53 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
Where Michigan sits
The same service costs 7.2 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Michigan· 23rd of 51
$1,288
AK $3,981UT $550
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.